Provider Demographics
NPI:1376598870
Name:MEHTA, RAJIL
Entity type:Individual
Prefix:
First Name:RAJIL
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-5001
Mailing Address - Country:US
Mailing Address - Phone:724-548-1395
Mailing Address - Fax:724-548-1396
Practice Address - Street 1:1 NOLTE DR STE 720
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7111
Practice Address - Country:US
Practice Address - Phone:724-548-1395
Practice Address - Fax:724-548-1396
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434777207RN0300X
OH35092152207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810013375Medicaid
OH2890153Medicaid
PA102212621Medicaid
OH2890153Medicaid
OHP00683149Medicare PIN